Wednesday, September 30, 2009

Public Option Is DOA in Health Care Debate

WASHINGTON (CNN) -- The Senate Finance Committee on Tuesday rejected two amendments to include a government-run public health insurance option in the only compromise health care bill so far.

Sen. Max Baucus said the public option provision would "hold back meaningful reform this year."

The amendments by Democratic Sens. Jay Rockefeller of West Virginia and Charles Schumer of New York were opposed by all 10 Republicans on the committee and a few Democrats, including committee Chairman Sen. Max Baucus of Montana.

Baucus explained that he liked much about the idea of a public option but that he knew a health care bill containing the provision would fail to win enough support in the full Senate to overcome a Republican filibuster.

"I fear if this provision is in the bill, it will hold back meaningful reform this year," Baucus said.

Rockefeller said that unfair practices by insurance companies required a not-for-profit alternative that would give consumers a lower-cost option and, in some cases, the only coverage they could get.

"They're getting away with banditry. They revel in it," Rockefeller said of tactics by insurance companies to avoid covering high-cost or high-risk consumers.

"I feel so strongly about it because it makes so much sense," he said. "The people I represent need this, because they're helpless" in terms of health insurance.

When I think about the Swiss Cheese health care insurance system in America, I don't think about Senator Max Baucus being able to count noses to pass a bill. I think about 47 millions of Americans without health insurance; I think about the thousands of people who lined up in Los Angeles the other day to get free health screenings. (The lines went on forever.) I think about local people who have been hurt by a lack of health care, such as the families which have to go around putting jars in convenience stores here to raise some money because their kid needs leukemia care and they have no insurance.

According to Oregon US Senator Jeff Merkley's office, a mother of two died from what she thought was bronchitis, but didn't go to a doctor because she wasn't insured, having changed her job. Turns out it was a lot worse than bronchitis, but she was self-medicating herself to save money on case her kids got sick. And she couldn't qualify for Medicaid, which his supposed to be for poor people, because she wasn't poor enough.

I know there's other anecdotes out there, and some would might support no public-options and such. I also know that medical insurance has gone up a lot faster than salaries. Three or four times as fast in some areas. The thing is the right-wing pretty much has won this battle. Despite polls saying that people favor a public option, its the senior citizens in the USA (ironically some of then being "tea party" rowdies who show up at Congressional Town Meetings and jeer any talk of a public option) who are by a 60-40 majority against the plan. Why? Because, at the root of it, they are afraid that there won't be enough government-sponsored medical protection to go around. They deny the benefit they receive even to people in th work force now who pay for their coverage through their payroll tax.

The irony is unalloyed.

Most seniors want to keep the benefits they are getting from the next generation. This is what American Individualism has sunk to--the government can send grandpa's grandson to war, but don't even THINK about taking a second look at grandpa's medical benefits! This is individualism? It's more like a mob beating people with oars who are trying to get into a lifeboat after a ship (the economy) has started to sink.

Consider this:

No single-payer program. Totally off the table.

No public option. They will still be some talk, but its done. Beaten. Obama has been backing away, calling the public option "just a sliver" of his program. It was one hell of a sliver if you ask me.

A Montana Senator named Baucus who has written a bill so favorable to the insurance industry they the industry is running commercials for "reform".

A lot of talk about "choices". Let the big insurance companies compete and they will create more choices. Choice is good, but the final good for me is affordability and security for Americans as citizens, not simply as wage-earners. This economy doesn't put people right back into jobs. 14,000 thousand people a day were losing their jobs a while ago. Most of them lost health care with that.

The American Constitution--which protected folks from big government-- was designed at a time when there was no Big Pharma, No Health Care Insurance Oligopolies, no hospitals built like mini-Taj Mahals with thousands of well-paid health care specialists, all on salary. I think part of this problem is that Americans are distracted with fighting a 19th Century war about Big Government. Mega-Businesses have a larger role in legislation through K-Street lobbyists in Washington then the Founders could have dreamed! Today over 60 percent of bankruptcies are caused by high medical bills, according to a Harvard study. I know my premiums go up and up. I don't expect a real universal health plan , but I do expect the end to people being denied insurance for pre-existing conditions and see more people covered by some form of public/private health care plan. And, for what it's worth, I think everyone should have to buy health insurance if they can because if they don't and get sick, its the public hospital that will pay for their care at the emergency room.

If you drive a car, you need car insurance; you have a body susceptible to disease or accidents, you need medical insurance.

If the French can do this, and the Swiss and the Brits (and not all their plans are the same either) then The United States should be able to produce enough compassion and practicality to do it too. But I guess we're too busy beating back the folks who haven't got on the lifeboat yet.

If a small country like New Zealand can run (not always perfectly I admit, but good enough) a publicly-funded universal health system, then the richest country in the world should be able to afford one.

Yesterday here in Multiply I read about a young Ohio student who died from pneumonia because she did not have health insurance, then on someone else's blog I read about a mother and her daughters all of whom had the same condition but the mother had decided to not take any more treatment so that her insurance company would fund her daughters' treatment instead. These things should be completely unacceptable but another person (from the US) commenting on that post couldn't see the immorality of it all. He seemed to think the situation was entirely ok because funds were not infinite. And it is true they are not, but when you have a properly funded health system there medical decisions get made based on the medical criteria of the patient and the benefits she/he will reap from that treatment. There are rules and guidelines laid down about how those decisions will be made in an ethical manner, not in an ad hoc fashion where a mother is forced to become her own death panel in order to get health care for her children.

I think people can only justify such a brutal system because they are so used to it that brutality has become normalised to them just as violence becomes normalised in an abusive household.

It's and interesting debate that is happening down there I like can't really relate to why this is such a touchy area. From looking at the outside in, it amazes me at how this is something so necessary yet there is more anger with it than the Iraqi war.

I really at time ponder if America knows what it wants and I say that with a respect.

It's not funny, Wren, but I don't blame folks in Canada for scratching their heads. If you say "Canadian Health Care", many Republicans will say "We're not Canada!" like its a completely different entity. Then they follow with how everybody in Canada wants the American system. (The funny thing is, they don't.)

And the reform was just to create a public option, not single-payer. We're I Canadian I'd "laugh" too.

There are places that have taken collectivism too far, like Pol Pot's Cambodia and Mao's China. Here, in my opinion, we have taken "rugged individualism" over the top. We're sacrificing people for paying off banks and fighting wars, as Wren put it so well.

Yes, where is the outrage. It's every little person and family unit for itself. Yaa-hoo! I think people aren't there because they know money is more powerful than voices, but I can't excuse my apathy. I've tried to talk to my Congressmen's office down here; one follow told me "Medicare is going broke, that proves government can't run health care." The idea I guess is that if it can't make a profit, it shouldn't exist even though Medicare has brought millions of elderly people out of poverty.

You can argue with that all you want but Greg Walden still gets reelected if he takes care of the big farmers and the bankers. The many reg'lar folks in places like Klamath Falls trust big companies over big government. A "Borderers" mentality if there ever was one.

I think the problem for US publicly funded health care is that there is no coherent grass roots model for it. The British welfare state which reached it's zenith in the late 1940s was based upon local initiatives like the Tredegar Medical Society in south Wales or the Peckham Experiment in London.http://en.wikipedia.org/wiki/The_Peckham_Experiment

I think these will have to develop from the ground up in the US as they did here, I think it is an absolute necessity now and is becoming more so in the UK too. The medical missionaries that provide the free health checks need to consolidate their practices and help establish local health initiatives based on ability to pay. One part of China that has not taken hold in the US infrastructure is the 'barefoot doctor' movement, America needs this attitude and Credit Unions should be talking to medical and nursing missionaries of the sort that are currently touring the country like travelling fairs. The welfare state will never be laid down by central government there are too many other more powerful interest groups at play there, it can only really be done by mutual aid and a creative way of viewing social welfare in the localities I think.http://www.thephf.org/

Excellent post by the way Doug, its taken me a while to catch up after being away and then plunging back into work, but I'm getting there bit by bit. This is a hugely important topic I think.

I think you are right, AA. It is clear to me now that there is no way many parts of the United States are united enough to support a true nationwide system of health care. Some states like Massachusetts, Vermont, Hawaii, Oregon and perhaps California have worked toward state health plans that are suited to the localities within the particular state. Obviously, this isn't grassroots perse and more local clinics and ad hoc programs that revolve around a health-blighted area are needed. The material on The Peckman Experiment is very interesting; the future of bringing down health costs in any developed nation is to keep people healthy and not wait for the effects of a bad living environment and lack of places to exercise and buy fresh food have to be factored in to a "wellness" strategy. There are movements like this in some inner-cities in America, but obviously more funding is needed . Some boosts in aid have been given by the Obama administration to locally-operated health care clinics. I'm not sure about any strings attached to the aid as of this writing.

But I agree strongly with you on this point: wagering for serious innovation from on-high in Washington or a state capitol swarming with lobbyists is a sucker's bet. The empathy movements in singular communities are our best hope. We cannot wait for the whole nation--especially the traditional places of political reaction like the conservative "good old boy" culture in the Rocky Mountain areas (like the states of Utah, Wyoming and Idaho) -- to get with the 21st Century right yet.

Good point, Iri Ani. I think that when it comes to the USA's health care non-system, the majority of working class and lower middle class Americans are suffering the public policy equivilent of "battered wife syndrome." We take the beatings from the system when we lose insurance or are denied adequate care by the insurers, but refuse to leave this non-plan because we feel we don't deserve better for ourselves and our neighbors.